NPIMap

Individual provider Active NPI

Michael Trung Pham, DO

  • Internal Medicine Physician
  • Carlsbad, CA
National Provider Identifier
1477940658
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A18260 Issued in CA
Practice address
2176 Salk Ave
Carlsbad, CA 92008-7346
Phone
(760) 827-7210
Fax
(760) 827-7225
NPI assigned
Apr 24, 2015
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 20A18260 CA
Student in an Organized Health Care Education/Training Program 390200000X 286997 NY
Internal Medicine Physician 207R00000X 20A18260 CA Primary

Addresses

Primary practice location

2176 Salk Ave
Carlsbad, CA 92008-7346

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 827-7210

Other practice location 1

4077 Fifth Ave
San Diego, CA 92103-2105
Phone (619) 686-3935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210409001858 CA Practitioner - Internal MedicinePractitioner - Hospitalist 6608129788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

2176 Salk Ave
Carlsbad, CA 92008-7346
Phone (760) 827-7200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A18260CAMDInternal Medicine Physician
286997NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine Current Accepting new patients
Scripps Health CurrentSince Jun 1, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

2176 Salk Ave
Carlsbad, CA 92008
Phone (760) 827-7200

2176 Salk Ave
Ste 200
Carlsbad, CA 92008
Phone (760) 827-7200

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1477940658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-827-7210",
            "fax_number": "760-827-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 SALK AVE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920087346",
            "telephone_number": "760-827-7210",
            "fax_number": "760-827-7225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4077 Fifth Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032105",
            "country_code": "US",
            "telephone_number": "619-686-3935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MICHAEL",
        "middle_name": "TRUNG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-24",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "20A18260",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "286997",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A18260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.